SAFE TRANSFUSION - PERSPECTIVE FROM THE BLOOD-SUPPLY AGENCY

Risk management concepts from the engineering literature suggest that a background risk of one in a million is the intuitive level of accept able risk. That risk level is being approached by the risk of transfus ion-associated malaria and HIV in Australia. However, the risk of tran sfusion error and the risk of transfusion-associated HBV is still unac ceptable by this standard. The risk of transfusion-associated HIV is i ntermediate. It is likely that improvement in the risk of transfusion- associated disease will come primarily from the extended use of autolo gous transfusions and by technological solutions. By its very nature, donor assessment is an inefficient way of selecting safe donors, gives progreSSively diminishing returns and is prone to failure.